1. Diabetes and the Foot The Road to Amputation?

2. FOOT ULCERS AND DIABETES
Lifetime risk 15%
2% of people with Diabetes per year
(60,000 pa)
24x more likely to suffer amputation
50% mortality in 5 years
84% of all major amputations preceded by ulcer
>£1 Billion per year
Cost of foot complications
This is what happen to 2% of people with diabetes.
60,00 in England and Wales
360 in Southampton
Commonest cause of hospital admission
!5% risk of ulcer during life time.
Patients with diabetes significantly more likely to loose their legs

3. THE FUTURE FOR A PERSON WITH DIABETES AND A FOOT ULCER
45%
25%
11%
17%
Jeffcoate et al, Diabetes Care 29:

4. DIABETES AND AMPUTATION
5 Years (2003-8)
25,578 amputations
100 week
40% Diabetes
National Variation
Rate: /100,000
Mortality: /100,000
Prior Intervention
56.7% no intervention
Cost
£50-75 million (0.5% NHS budget)
Holt P Unpublished data

5. OUTCOME AFTER AMPUTATION
Willrich et al, Foot & Ankle Int 26:(2)

6. WHY DO WE LET AMPUTATION HAPPEN?
Common
Poor outcome
Costly
Avoidable in up to 85% of people?
International Diabetes Federation